Pathways from adolescent screen time to eating related symptoms: a multilevel longitudinal mediation analysis through self-esteem.

OBJECTIVE

Screen time and self-esteem have been shown to be important correlates of eating disorders in adolescence. However, there is an absence of longitudinal studies that distinguish between time-varying factors, accounting for parallel developmental changes and common underlying vulnerability.

DESIGN

A total of 3,801 adolescents were administered self-report measures, annually, over the course of 5 years. The association of screen time (social media use, television watching, video gaming) on eating related symptoms was analyzed using a longitudinal Bayesian multilevel path analysis framework. Self-esteem was examined as a mediating factor in this model. This study investigated direct and indirect associations at between-person, concurrent within-person, and lagged-within-person levels, while controlling for gender.

RESULTS

The findings revealed that all types of screen time exposure were significantly associated with eating related symptoms at between and within-person levels. A significant association at the lagged-within person level was only revealed for social media use. Self-esteem was found to be a significant mediating factor between screen time and eating related symptoms.

CONCLUSION

An increase in social media use one year was associated with increased of eating related symptoms two years later through lower self-esteem. Implications for prevention are discussed.